A 32-year-old female with no significant past medical history except for a recent upper respiratory infection treated with antibiotics, presents with symptoms of fatigue, frequent infections, and unexplained bruising. Over the last few months, she noticed increased shortness of breath upon minimal exertion and an unusual tendency to bruise easily after minor bumps. Her symptoms escalated to include prolonged bleeding from minor cuts, leading her to seek medical attention. Initial blood work revealed severe pancytopenia with a hemoglobin of 7.5 g/dL, white blood cell count of 1.2 x 10^9/L, and platelets at 20 x 10^9/L. A bone marrow biopsy was conducted due to the suspicion of bone marrow failure. The biopsy confirmed the diagnosis of aplastic anemia, showing a hypocellular marrow with increased fat spaces and decreased hematopoietic cells. Which of the following can cause aplastic anemia?
A 25-year-old woman presented with fatigue, shortness of breath, and easy bruising. Her complete blood count revealed pancytopenia, characterized by a significant decrease in red blood cells, white blood cells, and platelets. A bone marrow biopsy confirmed severe hypocellularity, consistent with aplastic anemia. Further investigations, including viral serology, revealed a recent viral infection that can cause transient bone marrow suppression in immunocompetent individuals. Which of the following viruses can cause aplastic anemia?
A 26 year-old woman presents to your office and reports feeling usually weak and tired, having trouble concentrating, shortness of breath, especially with activity, pounding sensation in the ears, easy bruising from minor injuries and even brushing her teeth, frequent nosebleeds, heavy menstrual periods, and tiny red spots on her arms. Her past medical history is significant for three urinary tract infections in the last four months. She has no prior exposure to chemicals and reports no drug use. In physical examination, you notice a well-built, well dressed woman with no distress. She has pallor of conjunctiva, the skin and mucous membranes. There are petechiae and ecchymosis on both arms. She has resting tachycardia. You did not notice lymphadenopathy and splenomegaly. Suspecting a blood disorder, you ordered some laboratory tests. The results are as follows. Laboratory results: Neutrophil count: 498//μL; platelet count 19700/μL; hemoglobin 8.2 g/dl; corrected reticulocyte count 0.9% blood smear showed large erythrocytes with increased mean corpuscular volume (MCV). Paucity of platelets and granulocytes. No reticulocytes. Normal lymphocytes. Bone marrow biopsy: readily aspirated, mainly fatty biopsy specimen, markedly hypocellular devoid of marrow progenitors Which of the following is the most likely diagnosis?
A 22 year-old student from Italy visits your office for poor appetite, tiredness and weakness. You ran some laboratory tests which are significant for the following values. Hemoglobin: 10 g/dL (Normal 13.5-17.5 g/dL) Mean corpuscular volume (MCV): 55 μ m³ (80-100 μ m³) Red blood cell distribution width (RDW): 12.5% ( Normal range 11.5% to 14.5%) Serum ferritin: 170 (Normal 20-250 ng/mL) Hemoglobin electrophoresis: Hemoglobin A 87%; Hemoglobin A2 8%, Hemoglobin F 5% What is the most likely diagnosis in this patient?
A 67 year-old male patient came to your office for an annual physical examination and laboratory tests which are required by his health insurance company. He denies any symptoms such as fatigue, weakness, shortness of breath or chest pain.His CBC is significant for microcytic anemia. He reports that years ago he was diagnosed with a β-Thalassemia trait. What is the next best step in the management of this patient?
You are about to prescribe a few medications to someone who has been diagnosed with thalassemia. Which of the following medications is known to put oxidative stress on red blood cells even at therapeutic doses?
Of the following, what is the most common complication with which most patients with thalassemia major die of after receiving multiple transfusions?
